David Sinclair: Extending the Human Lifespan Beyond 100 Years | Lex Fridman Podcast

David Sinclair is a geneticist at Harvard and author of Lifespan.

This Podcast is a repost which originally appeared on lexfridman.com
Podcast notes are a repost which originally appeared on PodcastNotes
Lex Fridman Podcast #189 with David Sinclair - June 6, 2021
Edited for content and readability - Images sourced from Pexels

Key Takeaways

  • Wearables have the potential to revolutionize medicine
  • The goal is doctors being able to look at a dashboard of our body based on swabs, blood tests, and biosensors and make real-time, tailored recommendations
  • Top causes of aging: broken chromosomes, cell stress, smoking
  • Lifestyle methods to slow aging: fasting (skip 1-2 meals per day), eat more vegetables and less red meat, exercise, get good quality sleep (quality more important than quantity)

Introduction

Dr. David Sinclair (@davidsinclair) is a biologist, professor of genetics at Harvard, author, and expert on aging and longevity. His research and biotech companies focus on understanding why we age and how to slow its effects.

In this episode of the Lex Fridman Podcast, Lex and guest David Sinclair discuss the determinants of why we age, solving aging, the trend of wearables and tracking health data, artificial intelligence, social perspectives of lifespan , and death, and lifestyle factors to improve lifespan.

Host: Lex Fridman (@lexfridman)

Book: Lifespan: Why We Age and Why We Don’t Have To by David Sinclair

Artificial Intelligence & Immortality

  • We live in a time we can leverage data to have the pieces of the life of people we can gather using technology, beyond just written books
  • AI makes it possible to bring back people that we love in some way and in essence achieve immortality
  • AI can be used to build experience, thoughts, speech
  • AI uses in aging: generate biological clocks, predict protein folding, assemble genomes, predict longevity in mouse in response to stimuli, diagnosing a virus

David Sinclair Interest And Predictions On Wearables

  • Wearables represent the merging of machines and humans  
  • Wearables help us collect biological data about our bodies
  • We can use data to keep ourselves in optimal shape
  • “Picture a future where you’re monitored constantly so you wouldn’t have a heart attack, you’d know that was coming.” – David Sinclair
  • It’s feasible that wearables and similar technology will indicate what antibiotic or medication to take, what to eat, etc. – and augment physicians who would just need to sign off on the protocol
  • COVID-19 accelerated biological technologies & medical advances
  • There will be day doctor’s use wearable technology to send patients home for monitoring instead of keeping them in the hospital
  • Wearables will revolutionize medicine – it can collect data which can be used to predict sickness, diagnose disease

InsideTracker

  • InsideTracker: David Sinclair co-founded a company that creates personalized and actionable plans to help people optimize their bodies through nutrition, supplements, and lifestyle
  • Connects scientific papers to individual data and make recommendations for lifestyle
  • InsideTracker leverages hundreds of thousands of human data points and thousands of scientific articles to create a formula of what works and what doesn’t for your body
  • Recommendation of food and nutrition was better than leading drug at treating type 2 diabetes
  • Soon, the current model of medicine is going to outdated as machines and data will know us better than our doctor
  • “We wouldn’t drive a car without a dashboard so why would doctors do the same?” – David Sinclair

How And Why We Age

  • Aging is both a feature and bug of evolution
  • We only need to live as long as we need to in order to replace ourselves – some breed slowly and build a body that lasts, some breed quickly and die quickly
  • We can do better at aging
  • Hallmarks of aging include: loss of telomeres, senescent cells, loss of energetics
  • Defining factor of aging: preservation of information and loss of entropy
  • “Loss of information in our bodies is a root cause of aging.” – David Sinclair
  • We have information regulator genes in our bodies – upregulation could preserve health
  • Information in cells = DNA and epigenome
    • DNA is usually intact in animals and humans over time
    • Epigenome: regulators of genetic information
  • Question of importance: is there a repository of information in the body to restore from?
  • Antagonistic pleiotropy: a system built to keep us alive when we’re young but has damaging effects later in life
  • Causes of aging: (1) broken chromosomes and (2) cell stress – smoking also dramatically accelerates biological age
    • It’s hard to repair something that’s constantly breaking: we have 1000 chromosome breaks per day – the break is recognized by proteins and is usually fixed but not always
  • You can slow down aging using three embryonic genes to reset the age of tissues to a certain point – but if you don’t do it right it can cause tumors  

Data Sharing In Biology

  • “We’re living through what’s going to be seen as one of the biggest revolutions in human health through the gathering of data about our bodies.” – David Sinclair
  • Ultimately, we’re all going to be monitored
  • There will be a reversal where blamed will be assigned for not collecting data
  • Decisions are made based on very few tests when we have the opportunity to collect more
  • Consumer health is going in the direction of the patient having access to better data than the doctor (through private lab tests, biotech companies, etc.)
  • Doctors are becoming excited and interested about seeing and using privately collected patient data to make more informed decisions
  • The U.S. currently spends 17% of GDP on healthcare – we can save money by monitoring using wearables and prevention
  • Ideally, we can create a system where we can share data as we’d like and keep what we wouldn’t

Lifestyle Methods To Slow Aging

  • Fasting is one of the oldest ways to improve health – we need to optimize how long and the frequency
  • “If there’s one thing I can recommend to anybody to slow down aging it’s to skip a meal or two a day.” – David Sinclair
  • Note: David Sinclair is a big fan of one meal a day; the carnivore diet has made Lex feel really good
  • When you eat seems to be more important than what you eat
  • Data says plant-based foods are better than meat-based foods
    • People who live longer tend to eat Mediterranean diets with little red meat
    • High meat consumption stimulates mTor
    • Could take rapamycin to counteract effects of meat
    • Meat produces immediate health benefits (muscle, energy) but potentially at the expense of long term effects
  • Eat a diet full of leafy greens, avoid spikes in sugar, possibly explore supplementing with resveratrol
  • Exercise clearly extends longevity
  • You don’t need much exercise to get great benefit – exercise aerobically a few times per week (even 10 minutes) and lift weights a few times per week
  • Sleep is critical for longevity to avoid premature aging and adverse health outcomes
  • Sleep quality seems to matter more than quantity
  • The brain is the center for longevity so we have to take care of stress levels, mental health

Data Collection Methods

  • We’ll likely work to moving away from blood draws for data
  • Currently: swab and ship to the lab to test hormones, stress levels, blood glucose, etc.
  • In the next 10 years: spit on paper and stick in a machine for analysis
  • Home tests are really easy and scalable if they can become democratized (price reduced)

Realistic Goals Of Lifespan

  • If you start eating cleaner in your 20s, that has been shown to improve lifespan in animal models
  • If you are in your 20s, aim to reach 100
  • There’s no maximum limit to human lifespan

Death & Denial

  • We seem to draw meaning from life being rooted in our existence – most of us find it distressing to face our own mortality
  • All living beings have evolved to want to live and survive
  • It’s possible we evolve to naturally deny aging because we need to use our energy and focus for innovation and life instead of death
  • It might be easier to be lazy if you are immortal

Note: Wearable Oura ring was referred to multiple times throughout the show

Proteins could be key to long and healthy life

Developing drugs that target these proteins could be one way of slowing the ageing process, according to the largest genetic study of ageing.

This article is a repost which originally appeared on The University of Edinburgh
The University of Edinburgh - January 24, 2022
Edited for content and readability - Images sourced from Pexels
Source: https://www.nature.com/articles/s43587-021-00159-8

Our Takeaway:

  • 2 proteins are identified to have significant negative effects across ageing measures.
  • Individuals with raised levels these 2 proteins (LPA & VCAM1), are less likely to live longer lives.
  • High levels of LPA can increase the risk of atherosclerosis. Heart disease and stroke is also possible.
  • VCAM1 helps with blood clotting and the immune response and increases when it has detected an infection.
  • Studies are being done to lower these proteins when elevated.

As we age, our bodies begin to decline after we reach adulthood, which results in age-related diseases and death. This latest research investigates which proteins could influence the ageing process.

Many complex and related factors determine the rate at which we age and die, and these include genetics, lifestyle, environment and chance. The study sheds light on the part proteins play in this process.

Inheritance

Some people naturally have higher or lower levels of certain proteins because of the DNA they inherit from their parents. These protein levels can, in turn, affect a person’s health.

University of Edinburgh researchers combined the results of six large genetic studies into human ageing – each containing genetic information on hundreds of thousands of people,

Among 857 proteins studied, researchers identified two that had significant negative effects across various ageing measures.

People who inherited DNA that causes raised levels of these proteins were frailer, had poorer self-rated health and were less likely to live an exceptionally long life than those who did not.

Protein roles

The first protein, called apolipoprotein(a) (LPA), is made in the liver and thought to play a role in clotting. High levels of LPA can increase the risk of atherosclerosis – a condition in which arteries become clogged with fatty substances. Heart disease and stroke is a possible outcome.

The second protein, vascular cell adhesion molecule 1 (VCAM1), is primarily found on the surfaces of endothelial cells – a single-cell layer that lines blood vessels. The protein controls vessels’ expansion and retraction – and function in blood clotting and the immune response.

Levels of VCAM1 increase when the body sends signals to indicate it has detected an infection, VCAM1 then allows immune cells to cross the endothelial layer (a thin membrane that lines the inside of the heart and blood vessels), as seen for people who have naturally low levels of these proteins.

Improved ageing

The researchers say that drugs used to treat diseases by reducing levels of LPA and VCAM1 could have the added benefit of improving quality and length of life.  

One such example is a clinical trial that is testing a drug to lower LPA as a way of reducing the risk of heart disease.

There are currently no clinical trials involving VCAM1, but studies in mice have shown how antibodies lowering this protein’s level improved cognition during old age.

The findings have been published in the journal Nature Aging.

Grape seed extract may have anti-aging properties

Grape seed extract reverses aging in mice

Written by Timothy Huzar on December 9, 2021 — Fact checked by Anna Guildford, Ph.D.

This article is a repost which originally appeared on MEDICAL NEWS TODAY

Edited for content.

‧ Aging is a key risk factor for a range of health issues. This is due, in part, to the buildup of senescent cells in a person’s body.
‧ In recent years, scientists have identified a class of drugs called senolytics. These can destroy senescent cells in laboratory and animal experiments.
‧ In the recent study, the researchers identified a component of grape seed extract as a potentially effective senolytic, and they used it to extend the life span and healthspan of mice.


In a new study, researchers identified a new drug based on a component of grape seed extract that has successfully extended the life span and healthspan of mice.

The research, which appears in the journal Nature Metabolism, lays the groundwork for further clinical studies to determine whether or not the effects may be reproducible in humans.

Senescence and senolytics

Aging is a key risk factor for many chronic conditions. Scientists believe that this is due, in part, to cellular senescence. This occurs when a cell ceases to be able to fulfill its biological function in a person’s body.

In recent years, researchers have identified a class of drugs called senolytics. These drugs can destroy senescent cells in the laboratory and in animal models, potentially reducing the number of chronic conditions that occur with age and an increasing life span.

In the study, the scientists identified a new senolytic derived from a component of grape seed extract, known as procyanidin C1 (PCC1).

Based on previously available data, PCC1 showed promise at inhibiting the effects of senescent cells when administered at low concentrations and selectively destroying senescent cells at higher concentrations.

Mouse experiments

To test the effects of PCC1 on aging, the researchers developed three experiments involving mice.

In the first experiment, they exposed mice to a sub-lethal dose of radiation to induce cellular senescence. One group of mice then received PCC1, while the other group received the vehicle that carried the PCC1.

The researchers found that after the mice underwent irradiation, they developed abnormal body features, including significant amounts of gray hair.

Treating the mice with PCC1 significantly reversed these features. The mice who received PCC1 also had fewer senescent cells and fewer biomarkers associated with senescent cells.

Finally, the irradiated mice had worse exercise capacity and muscle strength. However, the mice that received PCC1 saw this reversed and had better survival rates.

In the second experiment, the researchers treated older mice with either PCC1 or a vehicle every 2 weeks for 4 months.

The team found a significant number of senescent cells in the kidneys, livers, lungs, and prostates of the aged mice. However, PCC1 treatment reversed this.

The PCC1-treated mice also had improved grip strength, maximum walking speed, hanging endurance, treadmill endurance, daily activity levels, and balance, compared with the mice who only received the vehicle.

In the third experiment, the researchers looked at very old mice to see what effect PCC1 may have on the longevity of the mice.

They found that mice treated with PCC1 lived, on average, 9.4% longer across their lifetime than mice who received the vehicle.

This equated to a 64.2% extended life span following the treatment.

Furthermore, despite living longer, the PCC1-treated mice did not have any greater age-related morbidity than the mice that received the vehicle.

Summing up the findings, corresponding study author Prof. Yu Sun — of the Shanghai Institute of Nutrition and Health in China — and colleagues say, “We hereby present proof-of-principle evidence that, even when administered in late life, [PCC1] holds prominent potential to remarkably delay age-related dysfunction, reduce age-related diseases, and enhance health conditions, thus providing a new avenue to improve healthspan and life span in future geriatric medicine.”

Speaking with Medical News Today, Dr. James Brown — a reader in aging and metabolism and a member of the Aston Research Centre for Healthy Ageing in Birmingham, United Kingdom — said that the findings provide further evidence for the potential benefit of senolytic drugs. Dr. Brown was not involved with the recent study.


“Senolytics are an exciting new class of anti-aging compounds, often found to be naturally occurring. This study suggests that PCC1 joins compounds like quercetin and fisetin in being able to selectively kill aged cells [while] leaving young and healthy cells alive and well.”


“This study, along with others in this field, looked at the effects in rodents and other lower organisms, and, therefore, there is much work to do before any anti-aging effect of these compounds in humans is established.”

“Senolytics certainly show promise as potentially being the leading class of anti-aging ‘drugs’ that are being developed,” said Dr. Brown.

Mice to humans?

Speaking with MNT, Prof. Ilaria Bellantuono — a professor of musculoskeletal aging at the University of Sheffield in the U.K. — agreed that a key question is whether or not the findings are reproducible in humans. Prof. Bellantuono also was not involved with the study.

“This research adds to a body of evidence showing that eliminating senescent cells using drugs [that] selectively kill those cells — called senolytics — improves physical function with age and enhances the action of chemotherapeutic agents in cancer.”

“It is to be noted that all the body of evidence in this area is in animal models — in this specific case, in mouse models. The real challenge is to test whether these drugs are as effective in [humans]. At the moment, there [are] no data available, and clinical trials are just starting,” said Prof. Bellantuono.

Dr. David Clancy — of the Division of Biomedical and Life Sciences at Lancaster University in the U.K. — said to MNT that the dose levels may be an issue when translating the findings to humans. Dr. Clancy was not involved with the recent study.

“Doses given to mice are often very large compared with what humans can tolerate. Proper senolytic doses of PCC1 in humans may turn out to cause toxicity. Rat studies might be informative; their livers apparently metabolize drugs more like humans’ than do mouse livers,” said Dr. Clancy.

Speaking with MNT, Dr. Richard Siow — the director of aging research at King’s College London in the U.K. — also said that nonhuman animal studies do not necessarily translate into positive clinical effects in humans. Dr. Siow also was not involved in the study.

“I don’t always equate findings in mice and worms and flies to humans, for the simple fact that we have bank accounts — they don’t. We have wallets — they don’t. We have other stresses in life that animals don’t have: dietary, social, work, Zoom calls. I’m sure you can stress out a mouse in different ways, but it’s usually the bank accounts we’re more worried about,” said Dr. Siow.

“It’s a joke, of course, but just to put it in context, you can’t translate everything that you read about in mice into humans. It’s great if you’re a mouse and you want to live to 200 — or the mouse equivalent of 200 — but is that meaningful for man? That’s always a caveat when I talk about animal studies.”

Nonetheless, Dr. Siow said that the findings were significant.

“On the positive side, it’s robust research, and it’s telling us about confirmatory evidence that many of the pathways that even my own research focuses on are important when we consider life span in general.”

“Whether it’s an animal model or a human model, perhaps we need to look at some of these particular molecular pathways in the context of human clinical studies with compounds such as grape seed procyanidins,” said Dr. Siow.

Dr. Siow said that one possibility was the development of grape seed extract as a dietary supplement.

“Having a good animal model with robust outcomes [and a paper] published in a high impact journal does add weight to the development and investment in human clinical studies, whether it’s from the government, clinical trials, or through investors and industry taking this on board, and based on these papers putting grape seed as a nutritional supplement in a tablet.”

“I’m taking nutritional supplements that may not have gone into clinical trials but based on evidence from animals, it adds weight — it gives the consumer confidence that there may be something in this. That’s one degree of translating awareness of nutritional supplements being beneficial in some respects for longevity,” said Dr. Siow.

Healthspan, not just life span

Dr. Siow stressed that the quality of a person’s life was also important, not just the number of years they live.

“If we look at life span, and more importantly healthspan, we need to delineate what we mean by life span. It’s OK that we live until 150, but if we spend the last 50 years in bed, that’s not great.”

“So, rather than life span, maybe a better word would be healthy longevity: You may well extend the number of years, but are you adding life to those years? Or are they meaningless years? And also mental health and wellness: You may be living to 130, but if you are unable to enjoy those years, is it worthwhile?”

“It’s important that we look at the broader perspective of mental health and wellness, frailty, immobility, how we grow old in society — are taking the pills sufficient? Or do we need more social care? If we’re living into our 90s, 100s, 110s, is there support in place? Is there government policy?”

“If these pills are helping us and we are getting into our 100s, what can we do to improve the quality of life — not just by taking more pills? There’s only so much you can do with grape seed and pomegranate and so on,” said Dr. Siow.

Future research

Prof. Bellantuono said that the study’s findings could be particularly valuable for developing clinical trials involving cancer patients receiving chemotherapy.

“The general challenge with senolytics is to identify [who] will benefit, and how to measure the benefits in a clinical trial.”

“In addition, as many of these drugs are most efficacious in preventing a condition rather than treating it when it is diagnosed, the clinical trials could last years depending on the conditions, and this is too expensive to do.”

“However, in this specific case, [the researchers] have identified a group of patients [who] will benefit from this: cancer patients undergoing chemotherapy. In addition, as it is known when the formation of senescent cells is induced — that is, with chemotherapy — and when the effects they cause on the tumor and physical performance occur — that is, weeks to [a] few months — this is an excellent example where a proof-of-concept study testing the efficacy of senolytics in patients could be performed,” said Prof. Bellantuono.










Olive Derivative Fights Biologic Kidney Aging

Researchers publishing in Aging Cell have discovered how and why oleuropein (OLP), a polyphenol derived from olives, improves biological kidney aging.

This article is a repost which originally appeared on ScienceDaily 
American Chemical Society - December 8, 2021 
Edited for content and readability - Images sourced from Pexels 
Study: https://onlinelibrary.wiley.com/doi/10.1111/acel.13526 

Our TLDR:

  • Olives contain oleuropein (OLP) (a polyphenol). Polyphenols are compounds that we get through certain plant-based foods.
  • A study was done on mice that examined the kidneys of both naturally aged mice and mice that were artificially.
  • There are two genes mentioned beneficial to mitigating aspects of aging in the kidneys (NRF2 and KLOTHO).
  • Researchers found that giving the aging mice OLP, previous markers of declining kidney function were also restored: macrophage infiltration was largely absent; levels of blood urea nitrogen and creatinine, two markers of kidney function, became closer to those of control mice; fibrosis was significantly reduced.

Upregulation and downregulation

Like nearly everything in biology, this specific part of kidney aging results from a chain of events. Here, the researchers show that DNA methyltransferases (DNMTs), which epigenetically suppress genes, are responsible for suppressing NRF2 and KLOTHO, two beneficial and antioxidant genes known to mitigate multiple aspects of aging, in the kidneys. This aspect of aging is suppressing the genes that fight other aspects of aging.

As the first step in demonstrating this, the researchers examined the kidneys of both naturally aged mice and mice that were artificially aged through the application of D-galactose (D-gal). In both sets of mice, KLOTHO and NRF2 were significantly downregulated. Fibrosis went up, macrophage infiltration went up, and the senescence marker SA-ß-gal was increased as well.

The researchers also analyzed DNMT levels in both sets of mice. Unsurprisingly, DMNTs and DNA methylation were elevated in both mouse models of aging. At 7 months in wild-type mice, DMNT1 was shown to be elevated; at 16 months, and further at 25 months, DMNT3a and DMNT3b were elevated as well. This was directly correlated with the decline in NRF2 and KLOTHO expression, whose gene sites were found to be heavily methylated.

Suppressing the suppressor

To determine a causal relationship between methylation and gene expression, and hopefully combat this aging, the researchers examined the effects of the synthetic drug SGI-1027 along with the potentially less cytotoxic OLP.

Both treatments worked as intended. Renal (kidney) DNA methylation was significantly decreased with both interventions, more so for SGI-1027 than OLP. Mice given both D-gal and OLP were shown to have only slightly higher amounts of DMNTs than control mice. The suppressor had been, itself, suppressed.

The researchers confirmed their findings by examining the downstream effects. As expected, NRF2 and KLOTHO expression were restored. The associated markers of kidney function were also restored: macrophage infiltration was largely absent; levels of blood urea nitrogen and creatinine, two markers of kidney function, became closer to those of control mice; fibrosis was significantly reduced. As a whole, the intervention was shown to be highly effective in this model.

The researchers then broke this causal chain in multiple places to prove its existence. First, they showed that using dimethyloxallyl glycine to suppress the effects of SGI-1027 and OLP on DMNT (suppressing the suppressor of the suppressor) prevented the positive changes. They also used silencing RNA to render mice deficient in KLOTHO, and these mice did not benefit from this treatment.

Conclusion

As usual, while the results were stark and highly significant, this was a mouse study. While a human study is much more expensive and involved, the significance of these results suggests that a clinical trial of OLP’s effects on kidney function might be the first step in bringing a potentially effective treatment to market, alleviating the suffering of a great many people suffering from renal disease.

Testosterone Levels: Can Specific Foods or Diets Boost Them?

Can Specific Foods or Diets Boost Your Testosterone Levels?

What you eat or drink may affect levels of the male sex hormone, but whether a diet can increase libido or energy depends on many things.

By Randi Hutter Epstein, M.D.

Nov. 2, 2021 Updated 12:15 p.m. ET

This article is a repost which originally appeared on The New York Times

Edited for content.

Can I increase my testosterone levels through the foods I eat? And if so, which foods or diets work best?

Many men, particularly as they age, are concerned about their levels of testosterone, the male sex hormone touted to build muscle, sex drive and vigor. But individual foods are unlikely to have an impact on testosterone levels — though drinking excessive amounts of alcohol might. If you are overweight, altering your diet to lose weight may help, since carrying excess pounds is a common cause of low testosterone. But in terms of specific foods or diets, any uptick you achieve may not have a noticeable impact on libido, energy or muscle mass.

“If someone was not overweight, I wouldn’t put them on a specific diet to raise testosterone based on the data we have now,” said Alexander Pastuszak, an assistant professor of urology and surgery at the University of Utah in Salt Lake City, who co-authored a review on alternatives to testosterone therapy.

In men, normal testosterone levels range from 300 to 1,000 nanograms per deciliter of blood. Ups and downs within that normal range are unlikely to have any impact on sex drive or vitality. Only when levels consistently drop below 300 points — as confirmed in two blood tests by an accredited laboratory — are symptoms like low libido, erectile dysfunction, fatigue, low mood or loss of muscle mass likely to appear, a medical condition known as hypogonadism.

Starting at around age 40, men’s testosterone levels start to decline by about 1 percent per year. But the drop can vary tremendously, with some older men maintaining levels similar to healthy young men. The trajectory of falling testosterone is steeper among men who gain a lot of weight, said Dr. Shalender Bhasin, professor of medicine at Harvard and the director of the Research Program in Men’s Health: Aging and Metabolism at Brigham and Women’s Hospital.

Studies on foods or diets and testosterone levels have generally been small and the findings far from conclusive. A recent British review that pooled data from 206 volunteers, for example, found that men on low-fat diets had testosterone levels that were about 60 points higher, on average, than men on high-fat diets. Men who followed a vegetarian diet tended to have the lowest levels of testosterone, about 150 points lower, on average, than those following a high-fat, meat-based diet. Still, Joseph Whittaker, the lead investigator and a nutritionist at the University of Worcester in Britain, said he would not recommend a man increase the fats in his diet unless he had low testosterone levels and symptoms of low T and was already restricting fats.

Another study in the Journal of Strength and Conditioning Research tested two styles of diets in 25 fit men between the ages of 18 and 30. Calories consumed were the same, but one group ate a high-fat, very-low-carb, ketogenic-style diet, consisting of 75 percent of calories from fats, 5 percent from carbohydrates and 20 percent from protein. Men in the other group ate a more traditional Western style, low-fat diet, containing 25 percent of calories from fats, 55 percent from carbohydrates and 20 percent from protein. After 10 weeks of eating the high-fat diet, testosterone increased by 118 points, on average, while after the low-fat diet, levels declined by about 36 points

Similarly, a study of 3,000 men found that those who reported eating a low-fat diet had slightly lower testosterone levels — about 30 points lower — than men who ate higher-fat diets. But none of the men had low testosterone.

“The moral is that healthy men who are of normal weight with no significant comorbidities are unlikely to benefit from restrictive diets,” said Dr. Richard J. Fantus, one of the study’s authors and a urologist at NorthShore University HealthSystem in Evanston, Ill.

Diet studies are complicated, because changing one component of the diet, such as fat intake, alters so many other things, such as the amount of carbohydrates, protein and micronutrients consumed. It’s unclear which component of the diet may have prompted the hormonal changes, Dr. Bhasin said. Furthermore, testosterone levels may also be shaped by how much a person sleeps, or whether they are jet-lagged, or if they are eating most of their calories at night or in small meals throughout the day.

Dr. Faysal Yafi, chief of the division of Men’s Health and Reconstructive Urology at the University of California, Irvine, says his patients who opt to follow specific diets tend to start exercising more and drinking less alcohol, all of which can raise testosterone levels. He suspects any links between diet and testosterone may be the result of an overall healthier lifestyle.

Some men worry that eating lots of soy foods may cause their testosterone levels to fall, because soy is rich in isoflavones, which mimic the structure of estrogen. But the evidence doesn’t support their concerns, even if men eat foods like miso, tofu or soy milk at every meal. (Doctors did report one anecdotal case in which a 19-year-old man with Type 1 diabetes who followed a vegan diet containing 360 milligrams of soy daily — nine times higher than a typical Japanese diet, and 100 times higher than the typical American diet — developed low testosterone levels along with low libido and fatigue. His symptoms improved when he stopped eating the soy-heavy, vegan diet.)

Long-term alcohol abuse lowers testosterone by damaging cells in both the testes, which make testosterone, and the liver, which alters testosterone metabolism. But binge drinking every now and then does not appear to have much of an impact — it lowers testosterone for only about 30 minutes, according to one study, after which levels bounce back to baseline.

Obese men who have low levels of testosterone can increase levels by cutting calories and losing weight — the type of diet does not matter, studies suggest. On the opposite extreme, Dr. Bhasin said he is seeing an increasing number of men at his clinic who have body dysmorphic issues and are suffering from low libido and fatigue. Strict calorie restriction, exercising intensely and being chronically stressed can all cause testosterone levels to plummet and are likely to blame, he said.

The bottom line is that for otherwise healthy men who are following a reasonably healthy lifestyle, fiddling with specific foods or the composition of the diet is not likely to make much of a difference on the testosterone score card. As Dr. Fantus of NorthShore University put it: “I don’t think there is a way to game the system to get really large increases by changing the diet.”

 

Sugar and Aging: What You Need to Know

People looking to extend their lives have a particular interest in sugar and aging, but what does the science actually say?

This article is a repost which originally appeared on Longevity Advice
Rachel Burger - September 13, 2021
Edited for content and readability Images sourced from Pexels

In a lot of diets, from the Mediterranean diet to the low-carb diet, all uniformly advocated for removing processed foods and refined sugar.

But mechanistically, why is sugar a problem? Does sugar contribute to aging? Are there nuances to the sugar-is-always-bad narrative?

In this article, I aim to answer all these questions. But first, I want to address a larger question: why is sugar talked so much in relation to health, nutrition, and aging?

Why is sugar a focus?

Humans are hardwired to love sweet foods.

You might meet the occasional adult who claims to hate sugar, but you’ve likely never met a kid who turned their nose up at a sweet. In fact, there’s a general consensus that sugar preferences in children are not a byproduct of advertising or food manufacturing, but of biological desires. A review published in the journal Clinical Nutrition and Metabolic Care explains, “Heightened preference for sweet-tasting foods and beverages during childhood is universal and evident among infants and children around the world.”

While “too sweet” is a concept adults are familiar with (they tend to max out at about what you’d get in a 20 oz Gatorade), there is no known upper limit to how much sweetness—sugar, by extension—kids like.

“Sugar” is shorthand for “simple carbohydrates.” There are two natural categories of sugars:

  • Monosaccharides: Simple carbs with a single sugar molecule. Glucose, fructose, and galactose are monosaccharides.
  • Disaccharides: Simple carbs with two sugar molecules joined together.

There are only three disaccharides that are naturally occurring. Sucrose, which you can find in table sugar, honey, and dates, is a combination of glucose and fructose. Lactose, or the combination of glucose and galactose, is natural milk-derived sugar, found in cream, butter, and human breast milk. Finally, there’s maltose, which has two bonded glucose molecules, which is found in germinating grains. Foods with maltose include beer and bread.

(Other sweeteners, like high fructose corn syrup, are man-made disaccharides [any of a class of sugars whose molecules contain two monosaccharide residues].)

Carbohydrates, regardless of if they’re simple or complex carbs, are used for four functions in the human body. As this is an incredibly dense topic, please use the links provided for further reading if you’re interested.

  • Producing energy: Most human cells prefer or require carbohydrates to produce energy and work as they’re supposed to.
  • Energy storage: Carbohydrates that aren’t immediately used are stored as glycogen.
  • Building macromolecules: Carbohydrates are used to make ribose and deoxyribose, the foundations of macromolecules like DNA and RNA.
  • Preserving fat and protein: Blood glucose spares the body from having to use fat and protein as the body’s main source of energy.

In other words, carbohydrates are an essential part of a functioning human body. Because simple carbs have a shorter chain of molecules, they’re easier to digest in the body. Over email, Julie Olson, BSc., CN, BCHN, CGP, of Fortitude Functional Nutrition, elaborates: “Carbohydrates are a main source of energy, converted by the body to power our cells. We need some sugar for some brain cells, some kidney cells, red blood cells, and testes cells” to function properly.

Simple carbs are a subject of conversation in nutritional circles because humans generally rely on carbohydrates to function, and humans particularly like sugar and its sweetness.

Unfortunately, our preference for sweets has led to an excess of added sugar in the Western diet.

Added sugar versus natural sugars

When I say “added sugar,” I mean simple carbs that have been mixed into foods during food processing. Natural sugars, by contrast, are simple sugars found in whole foods, like sugars found in fruits and vegetables.

Some sugars found in nature, like honey and maple syrup, are also considered added sugar.

The American Heart Association recommends consuming no more than 100 calories, or six teaspoons, of daily added sugars for females and children. Males can consume up to nine teaspoons, or 150 calories, of added sugars daily.

Unfortunately, the average American consumes 17 teaspoons of added sugar every day—that’s a 183% increase and an 89% increase from recommended daily intake for females and males, respectively.

And that excess sugar consumption has huge health consequences.

Sugar and aging

Added sugar increases the rate of biological aging. It does so in several ways. In 2018, the Annual Review of Nutrition published a systematic review of longitudinal studies on the correlation between high sugar consumption and cancer. They produced an infographic that aptly demonstrates just how much of the body added sugar ages and points to mechanisms as to why it does so:

This next section will drill down into three documented ways sugar and aging are intertwined: AGEs, inflammation, and diabetes. I’ll also cover a quick study on sugar’s effect on telomeres at the end.

Sugar and aging: a close look at AGEs

 

Let’s talk a bit about “advanced glycation end products,” or AGEs. AGEs are a diverse group of molecules that build up in human cells, particularly in muscle tissue and plasma. They’re created as a reaction between glucose and the amino acid glycine—when sugar meets fat or protein in the body. AGEs have a particularly resistant structure to degradation.

Emerging research suggests that AGEs form endogenously at an even higher rate with fructose than glucose—sweeteners like high fructose corn syrup, apple juice, honey, molasses, caramel, and agave syrup all contain fructose.

In other words, AGEs make your skin appear dry, saggy, and wrinkled—old. While AGEs age your insides, they also quickly age your exterior as well.

Diet is a major source of AGEs—barbecued meats, in particular, are full of them. They can also form while humans metabolize their food. AGEs formed in vivo tend to particularly affect “long-lived proteins, such as hemoglobinalkaline phosphataselysozymecollagen [and] elastin.”

There’s a general consensus in the scientific community that accumulated AGEs “are an inevitable component of the aging process in all eukaryotic organisms, including humans.” The more you have, the quicker you age.

Here’s why AGEs are a problem in large quantities: they’re linked to diabetes, cardiovascular disease, and renal disease. They’re also connected to Alzheimer’s disease and kidney disease. A whole host of studies demonstrate that AGEs trigger oxidative stress and excessive reactive oxygen species (which also cause oxidative stress).

Sugar and aging: chronic inflammation

Source: “Epigenetic signatures underlying inflammation: an interplay of nutrition, physical activity, metabolic diseases, and environmental factors for personalized nutrition

Inflammation is a biological defensive response to an irritant, like bacteria or viruses. If you skin your knee, the area around the cut will inflame, as a part of your immune system, to combat infection and to promote healing. Concentrations of white blood cells cause inflammation.

Inflammation can be short-term, or “acute.” If you’re like me and allergic to hay, your body will have an acute inflammatory response—an itchy, watery nose, a puffy face—until the irritant goes away. Inflammation can also be long-term, or “chronic,” and you can stay inflamed regardless if the trigger is still present.

There are a lot of age-related diseases connected to chronic inflammation. To name just a handfulthey include:

  • Diabetes
  • Cardiovascular diseases
  • Arthritis and joint diseases
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Certain kinds of cancer

Chronic inflammation can also help form AGEs.

Several studies have established that sugar, in all its forms, correlates with inflammation. Some studies have found that fructose appears to cause the most inflammation out of all of sugar’s forms, but that hasn’t been a consistent finding across all studies.

While it’s a mystery why some inflammation remains acute and other inflammation becomes chronic in some people and not others, sugar consumption is a significant precursor to chronic inflammation in many people.

Sugar and aging: diabetes

If you want to see a complicated cocktail of fact and misinformation, look closely at the relationship between sugar, obesity, and diabetes.

There is no known cure for diabetes, though diabetics can go into remission. Diabetes is the seventh-leading cause of death in the United States as of 2019.

Obesity is also a chronic disease. Obesity is defined as having a BMI, or a person’s weight in kilograms divided by the square of height in meters, of 30.0 or higher. According to Harvard Medical School, there are “genetic, developmental, hormonal, environmental, and behavioral factors” that contribute to who does and doesn’t have obesity.

Like diabetes, there are many treatments for obesity, but no known cure. One study suggests that if trends continue, all American adults will be either overweight or obese by 2048.

I choose to mention obesity and diabetes together because they have a significant causal relationship—obesity is an independent risk factor that can lay the groundwork for diabetes to developAlmost all (89%) of people with diabetes are obese or overweight. I found a massive range of estimates of how many obese individuals develop diabetes, from 2.9% to 30%. Many of the studies cited here look at both obesity and diabetes together as comorbid conditions. For example, hypertrophic obesity—what happens when fat cells enlarge more than normal—directly leads to insulin resistance.

Researchers have formally tied added sugar consumption to obesity and diabetes several times over. Though the relationship is complex and researchers don’t fully understand all mechanisms involved, it’s clear that added sugar consumption, particularly fructose, raises the risk of developing obesity and diabetes.

For example, foods high in fructose stimulate ghrelin while suppressing leptin—hormones responsible for hunger and satiety. Sugar can promote chronic hyperglycemia, which can both lead to weight gain and is another risk for diabetes. And sugary drinks, especially, are tied directly to obesity.

Sugar and aging: a bad combination (so what should we do?)

People looking to stay young for a long time should limit their sugar consumption. While how added sugar works in the body isn’t simple or predictable, there are literally thousands of studies tying added sugar to diseases of aging.

With all that said, it’s natural for humans to crave and eat limited amounts of sugar.

Sugar and aging is a massive topic with a lot of nuance—so much so that I didn’t even get a chance to cover alternative sweeteners.

What are your takes on sugar? What do you do to avoid them or to add them mindfully to your diet?